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Semester Three - Half Two - Nursing 212 > Conference Two - Module 5 (Exam 2) 2 > Flashcards

Conference Two - Module 5 (Exam 2) 2 Flashcards

1
Q

Fetal Elements

A
  1. FHR Baseline
  2. FHR Variablity
  3. FHR Periodic Changes (with contractions)
    1. Accelerations
    2. Decelerations
      1. Early
      2. Variable
      3. Late
      4. Prolonged
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2
Q

External Fetal Monitoring

A

Uses an ultrasound disc to provide information re FHR baseline, FHR variablity, and periodic changes. The optimal placement is over the fetal back.

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3
Q

Internal Fetal Monitoring

A

Uses a fetal scalp electrode (FSE) to provide greater detail

  1. Detects electrical impulses generated by fetal cardiac activity
  2. Eliminates potential interruptions caused by maternal or fetal movement during labor
  3. Requires rupture of membranes and minimal cervical dilation
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4
Q

Normal Fetal HR

A

110-160 BPM

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5
Q

Fetal Bradycardia

A

<110 BPM persisting for at least 10 minutes

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6
Q

Fetal Tachycardia

A

>160 BPM for at least 10 minutes

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7
Q

FHR Baseline

A

Average heart rate (rounded to 5 BPM), measured over at least two minutes within a 10 minute window

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8
Q

Fetal Bradycardia Possible Etiology

A
  1. Fetal Hypoxia
  2. Fetal Sleep Period (greater than or equal to 40 minutes)
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9
Q

Fetal Tachycardia Possible Etiology

A
  1. Maternal infectious process
  2. Maternal Dehydration
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10
Q

Nursing Interventionsfor Fetal Bradycardia and Tachycardia

A
  1. Monitor closely
  2. Increase placental blood flow/oxygenation to fetus
  3. Side-lyingposition
  4. O2
  5. IVF
  6. Collaborate to determine and address underlying cause
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11
Q

FHR Variability

A

The interplay between the fetal sympathetic and parasympathetic nervous system

Indicated by oscillations above and below baseline FHR, measured overat least two minutes during a ten-minute window

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12
Q

Moderate Variability

A

6-25 BPM above and below baseline

Indicates a well-oxygenated fetal nervous system and is considered very strong indicator of fetal wellness

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13
Q

Minimal Variability

A

less than or equal to 5BPM above and below baseline

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14
Q

Marked Variability

A

greater than or equal to 26BPM

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15
Q

Minimal Variability Etiology

A

Less than or equal to 5BPM

  1. Fetal Sleep Period
  2. Maternal Narcotic or sedative medication
  3. Fetal Tachycardia
  4. Fetal Sepsis
  5. Impaired Fetal oxygenation/hypoxia
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16
Q

Nursing Interventions for Minimal Variability

A
  1. Observe carefully
  2. Prepare to intervene:
    1. Side-lying position
    2. O2
    3. IVF
    4. Collborate to address underlying cause
17
Q

Marked Variability Etiology

A

Greater than or equal to 25 BPM

  1. CNS and/or cardiac anomlies
  2. Severe bradycardia
18
Q

Marked Varibility Nursing Interventions

A

Collaborate to address

19
Q

FHR Acceleration

A

An abrupt increase above the FHR baseline, peaking at a minimum of 15 BPM and lasting for at least 15 seconds (15X15)

  • Accelerations may be periodic (with contractions)
  • Accelerations may be non-periodic (independent of contractions)
  • Accelerations are considered a reassuring sign, indicating a well-oxygenated fetal nervous system
20
Q

Early Decelerations

A

Caused by fetal head compression and stimulation of the vagus nerve (slows heart rate). They have a shallow waveform, often mirroing the contraction. Benign.

21
Q

Late Decelerations

A

Caused by uteroplacental insufficiency and are always a serious indicator of potential for compromise. They literally occur later than a contraction.

22
Q

Variable Deceleration

A

Concerning. Caused by cord compression. They fall and rise abruptly, often dropping precipitously. Although they are most often periodic, they may also be non-periodic.

23
Q

Early deceleration etiology and interventions

A
  1. Head compression
  2. Often seen early active phase or with highly + station

Document and teach

24
Q

Late Deceleration Etiology

A
  1. Uteroplacental insufficiency
25
Q

Late Deceleration Nursing Interventions

A
  1. Remain with patient/report
  2. Left side-lying position
  3. O2 at 8-10 L VIA mask
  4. Stop Pitocin infusion/ increase IVF
  5. Potential urgent delivery
26
Q

Variable Decelerations Etiology and Interventions

A

Cord Compression

  1. Remain with patient
  2. Position changes: left, right, knee to chest
  3. O2 at 8-10L VIA mask
  4. Stop Pitocin infusion/ increase IVF
  5. Amnioinfusion (put fluid back in)
27
Q

Prolonged Decelerations

A

Duration 2-10 minutes

Prepare for urgent delivery

28
Q

Category 1

A
  1. FHR 100-160 BPM
  2. Moderate Variabilty
  3. No variable or late decelerations
  4. Possible early decelerations or accelerations
29
Q

Category 3

A
  1. Variable or late decelerations
  2. Bradycardia
  3. No variablity

Semester Three - Half Two - Nursing 212 (41 decks)

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